Cost effectiveness of a single-function treatment center for cataract surgery

Purpose: To compare the clinical and cost effectiveness of two models for cataract treatment: a single-function Cataract Treatment Centre (CTC) and a general ophthalmology service. Setting: Cataract Treatment Centre and the general ophthalmology service at Sunderland Eye Infirmary, Sunderland, United Kingdom. Methods: Two hundred patients were studied using two models of care: 100 in the CTC and 100 in the general ophthalmotogy service. Outcome measures were best corrected visual acuity at 3 months postoperatively or at discharge and occurrence of surgery-related complications. All direct costs to the National Health Service were identified, measured, and assessed. Results: Clinical outcomes in the two groups were similar. The average cost per patient was pound 496.90 ($760.25) at the CTC and pound 566.34 ($866.50) at the general ophthalmotogy service. The cost per patient treated as a day case in the general service group was pound 495.84 ($758.63). Thus, treatment at the CTC was more cost effective than in the mixed service group and as cost effective as in the day case subgroup. Conclusions: Depending on local circumstances, day care may be delivered more cost effectively in a single-function center than in a general ophthalmology service. We recommend day care using local anesthesia and protocols for assessment, surgery, and follow-up.